Case Manager

Job Title:  Case Manager

Department: IDD/SMI

Reports To: Program Manager

FLSA Status: Exempt

Summary:

Requirements and Duties:

• Completes case management workflow per identified process and documents timely within the electronic medical record within policy identified timeframes. 

• Assesses referrals to identify patient/significant others’ needs, level of intensity, insurance benefits and other patient resources.
• Make in-person face -to-face encounters (visits) in the clients home, office, or virtual calls to assess members current health status and engage client
• Completes all documentation including required assessments, case plans or IPOS, within required time frames, per policy and procedure. 
• Collaborates with appropriate key individuals to participate in the case plan or IPOS process and continues to involve and communicate as needed to ensure best possible outcomes for client. 
• Identifies gaps or barriers in the case plan or IPOS treatment plans 
• Initiates patient focused case plan or IPOS, coordinating services, appointments and care within required time frames and as needed
• Make appropriate client centered referrals to outside sources as needed to resolve barriers to access, social determinants of health or benefits
• Assesses the educational needs of clients, families and members of the health care team and provides, develops and implements appropriate teaching strategies or makes appropriate referrals.
• Provides client education to assist with self-management as needed based on case plan or IPOS; and delivers clinical support to members across a wide array of health topics and conditions

• Provides ongoing monitoring of clients progress toward treatment goals and objectives via ongoing face to face contact as directed by the Person-Centered Plan of Service

• Promotes high-quality care through adherence to quality standards for documentation, case management process and client satisfaction
• Collaborates with specialists, physicians, and medical/clinical directors (for both physical, behavioral health and substance abuse) to coordinate inter-disciplinary care team, and attends any necessary on or off-site meetings to ensure patients care is seamless
• Reviews reporting for trends and data in compliance, medication adherence, outreach failures, er utilization, and/ but not limited to inpatient admissions, and provides ongoing monitoring of client
• Ensures client is compliant with treatment plan, provider visits and medication regimen; fosters and promotes self-care management and independence in the client’s care.
• Facilitates and supports client compliance with appointments with provider, clinic, and therapist interactions as needed 
• Maintain compliance with all company policies and procedures and applicable rules and regulations of MDHHS, DWHIN, NSO, and any other entity NSO has entered into a partnership or contracted agreement.
• Coordinate with clients to ensure the correct identified resources are recommended or obtained within the client’s qualifying benefits or entitlement services
• Consults when appropriate to ensure adequate client caseloads

Required Qualifications:

• A bachelor’s degree in a Human Services Field 
• 2 or more years of community based in mental health as a case manager
• 1+ years of recent experience with a mental health/behavioral health clinical experience
• Roles that are interfacing with our children, adolescent, and teen population will require a total of 3 years working with minors or 24 hours of child-specific training (CEUs) to be certified by CMHP for MDHHS qualified provider.
• Excellent typing skills and ability to navigate a Windows based environment, experience in the use and navigation of an electronic medical record (EMR)
• Ability to navigate through an electronic medical record (EMR) and utilize Microsoft Products such as Outlook, Teams, Word, and Excel.
• Access to secure, high-speed internet and a dedicated, ability to work remote or within a hybrid role, with ability to protect health information and maintain HIPAA
• New Graduates in Social work are welcome. Limited Licensures candidates, candidates will need to be eligible to sit for licensure and pass within 24 months of employment social work, or a minimum of (5) eligible limited licensure renewals.

Preferred Qualifications:  

• Limited Licensed Social Worker (LLBSW or LLMSW), Licensed Social Worker (LBSW or LMSW), 
• Certified Case Manager (CCM) OR the ability to obtain certification within 24 months of employment
• Background in community-based care, mental health, behavioral health, homecare, or managed care case management
• Experience/ knowledge of discharge planning, resolving disparities in health care, urban populations, atypical home settings, and court ordered mental health care
• Experience in utilization review, concurrent review, or coding
• Experience in removing gaps in care, barriers or/ other disparities in healthcare

DISCLAIMER MESSAGE: